Cystic echinococcosis in Europe and in Italy

Cystic Echinococcosis remains a public health problem especially in the Mediterranean Region and the economic impact of Echinococcosis is great despite efforts to control it. In this review, an attempt is made to assess the present epidemiological situation of Echinococcosis in Europe and Italy.     

牛、羊包虫病及其实验室诊断技术

包虫病(echinococcosis)是由寄生于终末宿主(犬、狼、狐狸等)小肠的棘球蚴感染中间宿主(牛、羊、猪、骆驼、人类等)而引起的一种严重的人兽共患寄生虫病。该病在临床表现上缺乏特异性,且多为隐性感染,病原体不易检出,严重危害牧区人民健康和畜牧业发展。对包虫病的病原学特点、流行病学特点、实验室检测和诊断技术作一介绍,以期为该病的预防控制和进一步研究提供参考。     

细粒棘球绦虫抗原B的研究进展

细粒棘球绦虫抗原B(AgB)是血清学诊断棘球蚴病最重要的抗原,也是目前研究最多的抗原之一。深入研究抗原B对棘球蚴病的血清学诊断、流行病学研究、综合防控和疫苗的研究开发具有重要的意义。文章针对近年来关于抗原B的分子生物学特征、免疫学特性及在人和动物等中间宿主的血清学诊断方面的研究进展进行综述。     

棘球蚴病治疗方法研究进展

简述了外科手术和药物治疗棘球蚴病的研究进展,包括甲苯达唑等苯咪唑类、吡喹酮、这些药物脂质体新剂型及中医药物的治疗效果,并简述了药物联用的协同作用.     

牦牛棘球蚴病的调查与防制

1983年经过调查发现班玛县患棘球蚴病的牦牛1937头,发病率为99%。经过投喂丙硫咪唑、吡喹酮和采取有效的预防措施后,1997年和2005年再次调查,感染率分别下降为85.7%和64%。     

Book Reviews

WHO/OIE Manual on Echinococcosis in Humans and Animals: a public Health Problem of Global Concern. Edited by Eckert J, Gemmell MA, Meslin F-X and Pawlowski ZS
A Field Guide to the Mammals of Australia. Menkhorst P and Knight F     

Historical aspects of echinococcosis--an ancient but still relevant zoonosis

The history of echinococcosis in Europe includes a period of over 2000 years. Already in antiquity metacestodes (hydatids) of Echinococcus granulosus, the causative agents of Cystic Echinococcosis (CE), were observed in animals and humans. Alveolar Echinococcosis (AE), caused by metacestodes of E. multilocularis, was identified as a disease entity only in the middle of the 19th century. It took about 100 years until it was undoubtedly clarified and accepted that CE and AE are not caused by a single Echinococcus species, but by E. granulosus and E. multilocularis, respectively. In the 20th century significant progress has been achieved in echinococcosis research, including diagnosis, epidemiology, therapy, immunology, molecular biology and other fields. However, CE and AE remain actual problems as in many endemic regions resources and structures are lacking for effective surveillance and control of these zoonoses threatening humans.     

羊脑多头蚴病流行调查与防控

羊脑多头蚴病又被称为脑包虫病,是由多头幼绦虫幼虫寄生在绵羊脑组织中引发的一种人畜共患病。为进一步掌握中岭乡羊脑多头蚴病的流行现状,于2017—2018年,对该地区的藏羊脑多头蚴病感染情况进行调查,2年分别调查藏羊1323只和2122只,感染率分别为1.74%和2.26%,从感染情况分析,当地脑多头蚴病的发生相对较为严重,需要提高重视程度,制定更加完善的防控措施。     

羊C3d基因与细粒棘球蚴EG95s基因在杆状病毒中的串联表达

本研究通过构建含有3拷贝羊C3d基因与细粒棘球蚴EG95s基因的重组杆状病毒,旨在通过昆虫细胞表达EG95-(C3d)3重组融合蛋白,为原核表达和真核表达EG95-(C3d)3重组融合蛋白的免疫效果的比较奠定了基础。将细粒棘球蚴EG95s基因与3拷贝羊C3d基因串联,插入pTarget载体,获得重组质粒pTarget-EG95-(C3d)3,利用BamH Ⅰ和Xba Ⅰ双酶切位点将目的基因EG95-(C3d)3克隆至Bac-to-Bac系统的转移载体pFastBac-Hta中,获得pFastBacHta-EG95-(C3d)3重组质粒,将该重组质粒转化含穿梭载体Bacmid的感受态细胞DH10Bac中进行转座重组,获得携带3拷贝羊C3d基因与细粒棘球蚴EG95s基因的重组转座子rBacmid-EG95-(C3d)3,转染Sf9昆虫细胞后获得EG95-(C3d)3重组杆状病毒,并表达EG95- (C3d)3重组融合蛋白,采用SDS-PAGE和Western blotting进行重组蛋白的鉴定。同时利用昆虫细胞表达蛋白对羊棘球蚴病特异性抗体进行检测。结果表明,获得了EG95-(C3d)3重组杆状病毒,且EG95-(C3d)3重组融合蛋白在Sf9昆虫细胞得到了正确表达,大小约为132 ku,Western blotting鉴定结果显示表达的EG95-(C3d)3重组融合蛋白能与细粒棘球蚴阳性血清产生特异性反应,表明EG95-(C3d)3基因表达产物具有免疫活性。同时表达蛋白对羊棘球蚴病特异性抗体有良好的敏感性。EG95-(C3d)3基因在昆虫细胞获得表达,为原核表达和真核表达EG95-(C3d)3重组融合蛋白的免疫效果的比较,及细粒棘球蚴病的高效检测方法的建立奠定了基础。     

Case Reports

WHO/OIE Manual on Echinococcosis in Humans and Animals: a public Health Problem of Global Concern. Edited by Eckert J, Gemmell MA, Meslin F‐X and Pawlowski ZS A Field Guide to the Mammals of Australia. Menkhorst P and Knight F     

Echinococcosis in Slaughtered Reindeer (Rangifer Tarandus) in the Northern Part of Troms and Western Part of Finnmark Counties,During the Winter 1975/76

Echinococcosis in reindeer in Norway has been known for a long time. Meat inspection of 3712 reindeer in the winter 1975/76 revealed echinococci in 56 lungs (1.5 %). Forty-eight of the lungs were examined at The State Veterinary Laboratory for Northern Norway. Of these, 40 (∞ 83 %) contained well-developed cysts, while 8 (∞17%) contained only collapsed cysts. Five lungs (∞ 10 %) contained both well-developed and collapsed cysts.     

Cystic echinococcosis in the sheep: causes of its persistence in Sardinia

The authors analyse the current epidemiological situation of sheep Cystic Echinococcosis (CE) in Sardinia, where the prevalence of ovine CE is still very high (70%) and this parassitosis is also frequently found in the human population. For this reason Sardinia represents a peculiar model for CE study, because there are particular conditions that allow Echinococcus granulosus to complete its life cycle. Some social and economical factors support the persistence of sheep CE: over 3 million Sarda breed heads are extensively bred; the presence, at farm level, of a strong relationship between dog, sheep and human; the low commercial value of meat coming from adult sheep, whinch results in a large number of sheep being slaughtered at home or on the farm rather than in authorized slaughterhouses. Moreover Sardinia is the only Italian region where partially successful echinococcosis control plans have been applied. The authors suggest some indirect and direct initiatives, including the use of a new vaccine against the development of this metacestode in sheep, to reduce the prevalence of CE.     

Cystic echinococcosis in the sheep: causes of its persistence in Sardinia

The authors analyse the current epidemiological situation of sheep Cystic Echinococcosis (CE) in Sardinia, where the prevalence of ovine CE is still very high (70%) and this parassitosis is also frequently found in the human population. For this reason Sardinia represents a peculiar model for CE study, because there are particular conditions that allow Echinococcus granulosus to complete its life cycle. Some social and economical factors support the persistence of sheep CE: over 3 million Sarda breed heads are extensively bred; the presence, at farm level, of a strong relationship between dog, sheep and human; the low commercial value of meat coming from adult sheep, whinch results in a large number of sheep being slaughtered at home or on the farm rather than in authorized slaughterhouses. Moreover Sardinia is the only Italian region where partially successful echinococcosis control plans have been applied. The authors suggest some indirect and direct initiatives, including the use of a new vaccine against the development of this metacestode in sheep, to reduce the prevalence of CE.     

Cystic echinococcosis in Sardinia: farmers' knowledge and dog infection in sheep farms

Cystic Echinococcosis (CE) is one of the most widespread parasitic diseases in Sardinia, the second largest Mediterranean island where almost 3,558,000 milk sheep were raised extensively. The aim of this survey was to evaluate the level of farmers' knowledge on CE transmission, focusing on the role of human to facilitate the persistence of this zoonosis in Sardinia after 14 years after the last campaign against CE. The other goal of the survey is to update on presence of Echinococcus granulosus in its definitive hosts through three ELISA coproantigen tests. An interview was carried out with 172 farmers. The questionnaire was designed to include possible factors associated with the transmission of Echinococcosis: ownership and number of dogs, the use of anthelmintic drugs against dog cestode, frequency of anthelmintic treatment in dogs, home slaughtering and offal disposal. Individual faecal samples were retrieved from 300 dogs, and after a preliminary macroscopic examination to discover adult worms and/or proglottids, was submitted to copromicroscopic examination. Coproantigens were then extracted according to the protocol described by Allan et al. (1992), and subsequently stored at -20°C until use. Faecal soluble antigens from E. granulosus were detected using three different ELISA coproantigen assays: (a) the commercially produced Chekit Echinotest (Bommeli, Bern, CH) based on polyclonal antibodies against adult excretory/secretory (E/S) antigens; (b) a sandwich ELISA that uses rabbit polyclonal antibodies against adult E/S antigens and biotinylated monoclonal antibody EmA9 produced against adult Echinococcus multilocularis somatic extract (Malgor et al., 1997); and (c) a sandwich assay that uses monoclonal antibody EgC3 produced by immunization with adult E. granulosus E/S products (Casaravilla et al., 2005). Questionnaire results reveal that on all farms home-slaughtering was done, and offal was used as dog meal raw (17%) or after boiling (37%), discarded in the trash (23%), or buried superficially (15%). Most farmers (69%) declared to deworm their dogs, but only 10% used cestodicidal drugs. The coprological survey of 300 farm dogs using sedimentation, flotation and three different coproantigen (CA) ELISAs resulted in a faecal prevalence of 8.3% for taeniid eggs, while the CA tests gave prevalences of 3% (Chekit Echinotest, Bommeli), 6% (EmA9 sandwich ELISA) and 10% (EgC3 sandwich ELISA). Our results show that this is not only an educational problem, but also an economic one, stressing the need that future control plans should follow an integrative approach including veterinary and medical services, farmers, breeders' associations and the Government.     

Emergence of Echinococcus multilocularis among Red Foxes in northern Germany, 1991--2005

The parasite Echinococcus multilocularis is currently of great concern in Europe because of its spreading behavior, which has public health implications. This study investigates the spatiotemporal distribution of Echinococcus multilocularis in Red Foxes. The infection status of 8459 foxes was sampled from 43 regions in the north German province of Lower Saxony over three investigation periods 1991--1994, 1994--1997 and 2003--2005. Linear empirical Bayesian smoothing within the binomial model was used to produce smoothed choropleth maps. Geostatistical kriging was applied to generate prevalence risk maps. Further geostatistical modeling of the prevalence difference between study periods facilitated spatiotemporal trend investigations. The spatial scan statistic was used for cluster detection analysis. The average prevalence risk for Lower Saxony increased from about 12 to 20% during 1991--2005. Specifically the increases from first to second and to third study periods were estimated by 3.3% (CI 95%: 0.6%-5.9%) and 8.5% (CI 95%: 5.2%-11.8%), respectively. Infections in foxes were clustering and a location stable disease cluster was detected in the south of the province. This study is the first showing evidence for steady emergence of Echinococcus multilocularis in Red Foxes. First cases of human Alveolar Echinococcosis were recorded recently.     

Molecular epidemiology of Echinococcosis from food producing animals in north India

Echinococcosis is an important medical, veterinary and economic concern in India. Ten cysts were randomly selected from each intermediate host species (cattle, buffalo, sheep, goat and pigs). Either the germinal layer (sterile cysts) or protoscoleces (fertile cysts) were collected for molecular characterization. A 434 base pair fragment of the mitochondrial cytochrome oxidase-1 gene was amplified using PCR from each isolate. Ten representative samples (2 from each intermediate host species) were sequenced in both the directions from which readable sequences were obtained from nine for phylogenetic analysis (NCBI, Blast). Phylogenetic analysis of cytochrome oxidase I gene revealed that seven (77.7%) isolates, from cattle (2), pigs (2), buffaloes (1) and goat (2) were clustered with the Indian Buffalo (G3) strain of Echinococcus granulosus, while two (22.2%) isolates from sheep were clustered with the sheep strain (G1) of E. granulosus. Phylogenetic analysis of the cytochrome oxidase-1 gene revealed that the buffalo strain (G3) and common sheep strain (G1) are cycling among livestock in north India and that these strains are highly adapted to cattle, buffalo, sheep, goats and pigs.     

Control of cystic echinococcosis: Background and prospects

Cystic echinococcosis (CE), caused by Echinococcus granulosus, is a chronic and debilitating zoonotic larval cestode infection in humans, which is principally transmitted between dogs and domestic livestock, particularly sheep. Human CE occurs in almost all pastoral communities and rangeland areas of the underdeveloped and developed world. Control programmes against CE have been implemented in several endemic countries to reduce or eliminate the disease. New Zealand and Tasmania are examples of some of the first programmes to be undertaken (in insular territories) and which were very successful in the elimination of CE. The advent and proven effectiveness of praziquantel, plus the experience of insular models, produced high expectations for rapid advances in a second generation of control programmes undertaken in continental areas (Argentina, Uruguay and Chile). Nevertheless, only moderate gains in CE control have been made and the impact on prevalence among humans has been slight. A major impediment to the adoption of procedures that were successful in New Zealand and Tasmania has been the requirement to administer praziquantel to dogs in rural areas eight times per year over numerous years. In addition, there have been clear technological improvements made in the diagnosis of canine echinococcosis for surveillance, the genetic characterization of parasite strains and in vaccination against CE infection in livestock. In order to establish new paradigms and appropriate combinations of control strategies, we have carried out a review and discussion of the available control tools and control models. Control strategies must be suitable and sustainable to benefit the Echinococcosis–endemic areas primarily, which at the same time are the poorest regions of the world.     

Echinococcosis/hydatidosis: a severe threat in Mediterranean countries

Echinococcosis/hydatidosis is one of the most important parasitic zoonotic diseases in the world. Both cystic hydatidosis (CE) caused by Echinococcus granulosus and alveolar echinococcosis (AE) caused by E. multilocularis have been reported in several countries of the Mediterranean region (MR). E. granulosus has always been present in the MR and is the most common species. This parasite depends on the dog-sheep cycle and is actively transmitted in all pastoral regions where sheep, cattle and camelids predominate. E. multilocularis occurs only sporadically in limited areas of France, Serbia and Montenegro, Turkey, Tunisia and Morocco. However recent evidence indicates that it is spreading into other regions of the Mediterranean. Due to the lack of well-documented data, and to the fact that CE is not a notifiable disease in the majority of M countries, the precise incidence and prevalence of CE in humans and animals are not known. Published data suggests that prevalence is rather high in North Africa, Turkey, Greece, and in several regions of Italy and Spain. CE is an increasing public health and socio-economic concern due to the considerable morbidity rates that give rise to high economic losses both in the public health sector and in the livestock industry. Hospitalisation for human CE lasts from 2 weeks to more than 1 month in case of surgery. A number of factors contribute to the increase of prevalence and to the spreading of CE in the MR. These include the diversity of livestock production systems (predominantly extensive, traditional animal husbandry), small, ill-equipped and unsupervised slaughter-houses, illegal and family slaughtering, low public awareness of hydatid diseases, and the high population of stray dogs. Cyprus is the only country where an eradication programme has been successfully implemented. There have been, however, important developments in the last decade in CE epidemiology, in the diagnosis of canine infection, in strain characterisation and in immune strategies against CE in animals. This scientific progress, together with effective health education programmes, will likely improve control programmes and reduce the time required to achieve significant decreases in prevalence or eradication.     

Echinococcosis--an international public health challenge

This review aims to summarise some of the recent studies that have been undertaken on parasites of the genus Echinococcus and the diseases which they cause. Although the adult parasite, which inhabits the intestine of various carnivore species is not pathogenic, the larval or metacestode stages can be highly pathogenic, causing economic losses to livestock and various forms of echinococcosis in humans, some of which have a high fatality rate. There is growing evidence that there are at least 5 species of Echinococcus rather than the generally accepted 4 species. Within these species there are a number of genotypes or strains. This can have implications for surveillance and control. In some wealthy countries, cystic echinococcosis caused by Echinococcus granulosus has been successfully controlled or indeed eradicated. However, in most parts of the world it remains a serious threat to human health. In the former Soviet Union, the disease has rapidly increased in incidence after the end of communist administration. Human alveolar echinococcosis, caused by Echinococcus multilocularis, is more sporadic. However, in some Chinese communities there is a disturbingly high human prevalence and in Europe there has been an increase in the detection rate of E. multilocularis in animals in the last 10 years. Echinococcosis can present diagnostic challenges, particularly in the definitive host in areas of low endemicity. Much of the recent work relating to the use of coproantigen and PCR to overcome these difficulties is summarized. New ideas for controlling the parasite are becoming available and these include both the use of vaccination and the application of mathematical models to determine the most cost effective means of control. Effective measures that are affordable are vital if the parasite is to be controlled in poor countries.     

Surveillance of Echinococcus isolates from Qinghai,China

Echinococcosis is highly endemic over large parts of the Qinghai–Tibet Plateau (QTP), China. Based on a large number of samples, we present data on the current presence, host distribution, and genetic diversity of Echinococcus in the Qinghai Province, located in the northeastern corner of the QTP and constituting >25% of the area of the plateau. We used 521 samples (including 451 newly collected samples and 70 samples from our previous study) from humans, yaks, sheep, goats, dogs, fox, plateau pikas, and voles in 36 counties, and genotyped them using the mitochondrial DNA marker cytochrome oxidase subunit I (cox1) gene and the maximum parsimony and Bayesian reconstruction methods. Based on the 792 bp sequence matrix, we recorded 177 variable sites; 157 were parsimony-informative. A total of 105 haplotypes (H1–H105) were detected, of which H1–H15 and H90–H104, H16–H17, H18–H89, and H105 belonged to Echinococcus shiquicus, Echinococcus multilocularis, Echinococcus granulosus, and Echinococcus canadensis, respectively. Our results showed that, (i) the Qinghai Province was under a high burden of Echinococcus epidemiology; (ii) E. granulosus was the main echinococcosis threat to the local people, and the followed is E. multilocularis; (iii) there are a considerable number of haplotypes shared by domestic animals (sheep, yaks, and dogs) and humans, demonstrating the close relationship between human and domestic animals epidemiology; (iv) the threat of E. shiquicus on humans and livestock can be mostly ignored, while the infection risk of E. canadensis echinococcosis should not be neglected.